Select Few To Decide Health Care In Lakewood?

Hospitals occupy a unique place in human experience. They are the backdrop for life and death, joyful anticipation and sorrowful loss. Perhaps because they are where we experience these mysteries, hospitals seem imbued with an otherworldly quality. The soft glow of monitor screens, the seemingly endless chirping of IV pumps, the gleam of stainless steel, starched white linen, muted earth-tones, the bustle of activity at nursing stations. It's small wonder that hospitals are etched into our emotional memories.

Our hospital has seen generations come and go and its walls have witnessed much unbridled laughter as well as whispered prayers. Will it be retired to a pile of gray stone and mortar? Who will make this decision?

Many developments in the proposal between the Lakewood Hospital Association (LHA) and the Cleveland Clinic to raze the current hospital making way for a new Clinic-owned and -operated Family Health Center have come to light in the past month. The details of the plan were outlined in a January Letter of Intent that essentially would have all $158 million of hospital assets ceded to the Clinic in exchange for approximately $75 million that would be paid to a new non-profit entity charged with “wellness” in Lakewood.

LHA trustees and board members maintain the Clinic's assertion that the hospital is worth no more than $24 million after all liabilities are settled. However, financial details of the plan have been released only with persistent questioning.  Coupled with the LHA's track record of allowing services to be farmed out to Fairview Hospital, the fact that this closure has been contemplated behind closed doors for at least two years with scarce public notice, the recent revelation by Senator Skindell that the final deal hammering out the details of the plan has already been drafted in contradiction to what City and Hospital officials have been saying, and the lack of basic due diligence such as obtaining more than the quote offered by the buyer, has put Lakewood citizens on high alert. 

It has also led City and LHA officials into some awkward conversations. One LHA official informed me that the Hospital was actually not being “sold” to the Clinic but was merely being “transferred” since the Clinic is also a private non-profit.  

However, the proposed plan must be approved by City Council. City Finance Director Jennifer Pae addressed details of the current deal between the City and the LHA in a recent communication: “On January 5, 1987, City Council approved an agreement which resulted in the transfer of all real and personal property of the Hospital to the Lakewood Hospital Association. The agreement resulted in the City of Lakewood transferring all liabilities, debts, monies, accounts, and inventories of the Hospital so that operations would continue... As part of the agreement, the Lakewood Hospital Association agreed to pay in each year the amount necessary to satisfy debt service on the Hospital's outstanding debt. While the City retains title to all assets and the Association debt is pledged by the full faith, credit and general revenues of the City.” 

If it was true that the LHA owned outright the physical plant and real estate of the hospital, then City Council's approval would not be required. This begs the question: Is the City, and therefore every tax-paying Lakewood resident, being cut out of a multi-million dollar deal for lack of a voice?

While it remains an open question whether the days of having our own hospital have passed, there resides in that space an opportunity to create something new, perhaps something never thought of before. A model of health care inspired by the desire to help those who are hurting and that challenges the current paradigm of insurance companies and HMOs, perhaps.  

Accepting that the assumptions in the proposed deal are correct and that the Clinic is the best (or only) buyer in the market leaves the matter of the $75 million that is to be handed over to a new non-profit charged with “wellness.” 

Setting aside for a minute the nebulous heading of “wellness” that could mean quite a range of things for different people depending on demographic factors, is the crucial question: who exactly gets to determine what is done with what is essentially public monies derived from the sale of a public asset?

The scuttlebutt around town ranges from a recreation center to soccer fields.  Based on a January 21 presentation given to the Lakewood Hospital Community Advisory Council, the Active Living Task Force seems interested in the job. But what qualification does this group possess to determine the agenda of "wellness" in Lakewood and to receive $75 million of taxpayer money to accomplish it?  What exactly is the Active Living Task Force proposing? Why haven't these plans been announced publicly? Are there plans for a vetting process that consider other institutions or ideas of how to use the $75 million which culminate in a public vote? What sort of oversight controls will be in place?

Do we need more yoga studios? There are plenty of studies that show a strong correlation between flexibility and core strength and reduced falls in our older citizens; falls which have high degrees of morbidity and mortality. Does that qualify? What about an indoor pool? Oh, wait, I can pay $40 a month at the Lakewood YMCA and also have access to great fitness programming, it's centrally located, and wouldn't use money from a public resource.  

No matter what, the decision regarding what should be done with the proceeds of the sale of the hospital should be made by the community after thoughtful debate and not just by an elite group. To allow this would be to repeat the mistake --once again entrusting essentially the same private non-profit body that hobbled the hospital in the first place-- with the public good.